Southern California -- this just in

The state’s largest doctors group is opposing healthcare legislation being debated in the Senate this week, saying it would increase local healthcare costs and restrict access to care for elderly and low-income patients.

The California Medical Assn. represents more than 35,000 physicians statewide, making it the second-largest state medical association in the country after Texas.

The group’s executive committee met last week to discuss the Senate legislation proposed by Majority Leader Harry Reid (D-Nev.) on Nov. 18, also known as the Patient Protection and Affordable Care Act. Association leaders plan to issue a news release detailing their opposition later today, spokesman Andrew LaMar told The Times.

They join a handful of other state medical associations that have opposed the bill in recent weeks, including Florida, Georgia and Texas.

“The Senate bill came so short that we could not support it, even though we solidly support healthcare reform,” said Dr. Dev GnanaDev, medical director at Arrowhead Regional Medical Center in San Bernardino, who also serves on the association’s executive committee.

Doctors who oppose the Senate bill are concerned that it would would shift Medicare funding from urban to rural areas, move responsibility for Medicare oversight away from Congress by creating an Independent Medicare Commission and, ultimately, decrease Medicare reimbursement rates.

Medicare reimbursements would decrease 40% in coming years under the Senate bill, LaMar said. California doctors already contend with some of the lowest MediCal reimbursement rates in the nation, and although those rates would not change under the Senate bill, the pool of people eligible for coverage would increase. Only about a third of California doctors currently accept MediCal, and GnanaDev said that would likely grow under the Senate plan.

“If the doctors can’t see you, the only choice you have is the emergency room, which is a very bad way to get healthcare,” he said.

Healthcare legislation passed by the House would raise Medicare reimbursement rates on what LaMar said the association considers “a much more reasonable scale.”

“The House has made a real effort to try to address the issue,” LaMar said. “We feel they’re much more on the right track.”

However, the association has not endorsed the House bill, which was backed by doctors last month at the national convention of the American Medical Assn. in Houston. The AMA has not taken a position on the Senate bill, although it also oppose provisions that would lower Medicare reimbursement rates.

“The Senate bill includes provisions that we support and some provisions that we oppose. The AMA is working to have the Senate fix the Medicare physician payment formula once and for all, modify the proposed Medicare Advisory Board and prevent an ill-advised redistribution of Medicare payments based on flawed data,” said Dr. Rebecca J. Patchin, chair of the AMA. “Given the potential for multiple amendments, the AMA is reserving judgment on final passage of the Senate bill until later in the Senate floor debate.”

CMA officials have made their position clear to California Sens. Barbara Boxer and Dianne Feinstein, LaMar said, and have been told the senators are conveying their concerns to congressional leaders. Boxer supports the bill; Feinstein has not yet taken a position.